When the Body Was a Laboratory
Unit 2 established that slavery transformed the Black body into property — into a commodity bought, sold, insured, and entered into ledgers alongside livestock and tools. This lesson examines a specific and underexamined dimension of that commodification: the use of enslaved Black bodies as subjects of medical experimentation, anatomical dissection, and surgical practice, without consent and without anesthesia, in ways that produced knowledge and careers for white physicians while producing nothing for the people whose bodies were used.
This history is not a footnote to American medical history. It is foundational to it. And it has direct, documented consequences for Black Americans' relationship to medical institutions today.
J. Marion Sims and the Founding of Gynecological Surgery
J. Marion Sims is widely credited as the father of modern gynecological surgery. His statue stood in Central Park in New York City until 2018, when it was removed following sustained advocacy by medical ethicists and community organizations. His portrait hangs in the National Portrait Gallery. His name appears on hospitals and medical schools.
He developed the surgical techniques that made modern gynecology possible by operating, repeatedly and without anesthesia, on enslaved Black women.
Between 1845 and 1849, Sims performed approximately 30 surgical procedures on an estimated 11 enslaved women in Montgomery, Alabama, to develop a repair for vesico-vaginal fistula — a devastating tear between the bladder and vagina, often caused by prolonged labor, that caused constant urinary leakage and social isolation. The condition needed treatment. The way Sims developed that treatment was the problem.
The women were not volunteers in any meaningful sense. They were enslaved — the property of their enslavers, not free to refuse participation. Sims operated on each of them multiple times — one woman named Anarcha underwent at least 30 operations. He did not use anesthesia, arguing that Black people felt less pain than white people — a belief that was medically false and that he could not have verified, since he did not ask his patients.
The belief that Black people have higher pain tolerance than white people — that their skin is thicker, their nerve endings less sensitive — was not an idiosyncratic opinion held by Sims alone. It was widespread in 19th century American medicine, embedded in medical textbooks, and used to justify both the withholding of anesthesia and the conditions of enslaved labor. It had no scientific basis. It was racial ideology wearing the costume of medicine.
Anatomical Dissection and the Cadaver Trade
The development of modern surgery and anatomy required cadavers — human bodies for dissection and study. In the 19th century, the legal supply of cadavers was extremely limited: in most states, only the unclaimed bodies of executed criminals could be used for medical education.
The demand vastly exceeded the legal supply. Medical schools depended on a shadow economy of grave robbing and cadaver trafficking to obtain the bodies they needed.
In this shadow economy, Black bodies were disproportionately targeted:
- Black cemeteries were robbed at dramatically higher rates than white cemeteries, because Black communities had less political power to protect their dead and less recourse when violations occurred
- In some Southern states, the bodies of enslaved people were legally available for medical use without family consent
- Medical schools in both the North and South maintained relationships with grave robbers and cadaver suppliers who targeted Black burial grounds
- Some medical schools in the South used the bodies of enslaved people for anatomical instruction as a matter of routine
Medical historian Harriet Washington, in Medical Apartheid (2006), documented the cadaver trade in forensic detail, including the names of specific medical schools, specific suppliers, and specific documented violations.
The families of the dead had no recourse. The knowledge generated from their relatives' bodies was used to train physicians who would go on to treat white patients with preference and Black patients with neglect.
The Nott-Cartwright School: Scientific Racism and Medicine
The medical exploitation of enslaved people was not limited to surgery and dissection. It extended to the production of scientific theories specifically designed to justify slavery.
Samuel Cartwright, a Louisiana physician, published papers in the 1850s arguing that Black people were a biologically distinct and inferior race requiring enslavement for their own wellbeing. He invented diagnoses:
- Drapetomania: A supposed mental illness that caused enslaved people to desire freedom and attempt to escape. The "cure" was whipping.
- Dysaesthesia aethiopica: A supposed condition causing "insensitivity" and "rascality" in free Black people — Cartwright's medical explanation for why free Black people were not productive workers under slavery's conditions.
These were not fringe theories. They were published in respected medical journals, cited in pro-slavery political arguments, and taught in some medical schools.
The Nott-Cartwright school of medical racism — the systematic production of biological theories of Black inferiority within medical institutions — established a framework that persisted in American medicine well into the 20th century and whose residue can be documented in contemporary medical practice.
The Legacy That Lives in the Present
The medical exploitation of enslaved people is not simply historical. It has documented contemporary consequences:
The pain bias: A 2016 study published in the Proceedings of the National Academy of Sciences (Hoffman et al.) surveyed medical students and residents about their beliefs regarding biological differences between Black and white patients. Half of the respondents endorsed at least one false belief about biological racial differences — including the belief that Black patients have thicker skin or less sensitive nerve endings. Respondents who held these false beliefs were less likely to accurately assess and treat Black patients' pain.
Sims's belief that Black people feel less pain was not eliminated from American medicine in 1865. It persisted, in attenuated form, into the 21st century medical training environment.
Medical distrust: The history of medical exploitation — from Sims's experimental surgeries through the Tuskegee syphilis study (covered in the next lesson) to contemporary documented disparities in pain treatment — has produced a documented pattern of Black Americans' distrust of medical institutions. This distrust is rational, historically grounded, and has real consequences for health outcomes: people who distrust medical institutions delay seeking care, are less likely to participate in clinical trials, and are less likely to follow medical advice.
Understanding the history is not an argument against seeking medical care. It is an argument for understanding why distrust exists, what it is responding to, and what medical institutions must do to earn trust rather than simply demanding it.
The Henrietta Lacks Case: Exploitation Without Consent in the 20th Century
The exploitation of Black bodies for medical knowledge without consent did not end with slavery.
In 1951, Henrietta Lacks, a Black woman from Baltimore, was treated for cervical cancer at Johns Hopkins Hospital. Without her knowledge or consent, a sample of her cancer cells was taken and given to researcher George Gey, who discovered that her cells could survive and reproduce indefinitely in a laboratory — the first human cells to do so.
The HeLa cell line — named for Henrietta Lacks — became one of the most important tools in 20th century medical research. It was used to develop the polio vaccine, cancer treatments, in vitro fertilization techniques, and hundreds of other medical advances. The HeLa cell line has been used in over 70,000 scientific studies and has contributed to at least 11,000 patents.
Henrietta Lacks died of her cancer in 1951. Her family did not know her cells had been taken, did not consent to their use, and did not benefit financially from the billions of dollars in medical and commercial value her cells generated. They learned about HeLa only in the 1970s, when researchers contacted them for genetic information.
In 2023, a federal judge dismissed a lawsuit brought by Lacks's descendants against Thermo Fisher Scientific, a company that had commercialized HeLa cells, on the grounds that the statute of limitations had expired.
The case is not historically distant. It is a direct line from Sims's surgical experiments on Anarcha to the present.
